Getting started in pain services

Effective management of chronic pain calls for an holistic approach and could draw on skills developed in the management of other chronic conditions, says Professor Roger Knaggs (Specialist Pharmacist in pain management, Nottingham).

There is only limited evidence at present relating to the impact of pharmacy-led pain services. Moreover, the available evidence comes largely from the USA rather than the UK or mainland Europe.  Like many specialist pharmacy roles, the pain specialist role has developed over time but has not yet been formally evaluated.  There is still room for research in this area, acknowledges Professor Knaggs

For pharmacists who think they might like to specialise in pain services, Professor Knaggs’ advice is “Go and explore – talk to people, perhaps in your local institution whether that be a hospital or a GP practice”.  One of the most rewarding features of working in pain is that much of the work calls for an holistic approach rather than an approach based on medicines alone, he says. “Whilst the focus may be medicines, you are needing to use other skills and expertise as well to maximize benefit and have the best outcomes for the individual.  I think that you can draw upon skills from managing other long-term conditions, particularly in terms of managing chronic pain”, he adds.

When it comes to getting started Professor Knaggs says, “One very good place to start …. is acute surgical pain and promoting rational use of medicines …..  If you’re working in hospital this may well be an area [to develop], particularly if you’re working as a surgical pharmacist and seeing patients in the early post-operative period and working closely with the acute pain service …… If you’re working in community or in in Primary Care having discussions with your colleagues may well be a way in which you can begin to develop an interest in seeing patients both with acute pain and chronic pain”.

Roger Knaggs BSc BMedSci PhD EDPM FFRPS FRPharmS FFPMRCA, is Associate Professor in Clinical Pharmacy Practice, University of Nottingham and Specialist Pharmacist in pain management, Primary Integrated Community Solutions Ltd.

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